<extend name="_Layout/main"/>
<block name="main">



    <div class="builder-container builder-form-container">
        <div class="row">
            <div class="col-xs-12">
                <form action="{:U('Admin/Jihuoma/chulifafang')}" method="post" class="form builder-form">
                    <div class="form-group item_config[WEB_SITE_TITLE] ">
                        <label class="item-label">发至用户:<span class="check-tips">（<span class="small">请输入发至用户名</span>）</span></label>
                        <div class="controls">
                            <input type="text" class="form-control input text" name="username" value=""> </div>
                    </div>
                    <div class="form-group item_config[WEB_SITE_TITLE] ">
                        <label class="item-label">发放数量<span class="check-tips">（<span class="small">请输入发放的数量</span>）</span></label>
                        <div class="controls">
                            <input type="text" class="form-control input text" name="total" value=""> </div>
                    </div>
                    <button class="btn btn-primary" type="submit" target-form="builder-form">确定</button>
                </form>
            </div>
        </div>
    </div>

</block>